Revenue Cycle Patient Financial Advisor

1 week ago

Temecula, United States Rancho Health MSO Full time
Job Summary:

The intent of this job description is to provide a summary of the major duties and responsibilities performed in this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description.

The Patient Financial Advisor is responsible for ensuring accurate, timely filing of medical claims and bills to various payers and patients. This process includes review of medical encounter notes, for appropriate procedure codes, diagnoses, and modifiers. The candidate will ensure a positive patient experience, by helping patients understand their bill. Ability to assist patients with billing related inquiries and understand guidelines for setting up payment plans, soft collections, and bad debt collections. Works with the collection and statement vendors on patient collection activities. Understanding of the full revenue cycle including billing, payment posting, AR follow-up and financial reconciliation. Meet and exceed revenue cycle Collection goals. Candidate can communicate effectively with providers and clinical staff on insurance billing and documentation guidelines. Serve as a resource to appointment and registration staff regarding appropriate insurance selection, assisting patients with understanding statements and collection policies. Other job duties as assigned.

Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • Reviewing medical documentation and billing for errors, to ensure a clean claim is submitted the first time.
  • Manages phone lines and responds to patient calls and questions.
  • Manages chat lines and responds to Operations inquiries.
  • Follow up on unpaid and denied claims.
  • Insurance and patient payment posting and reconciliation.
Required education and experience: The requirements listed below are representative of the knowledge, skills, and/or ability required.

Minimum Education required:
  • High school graduate or equivalent.
  • Medical billing or coding certification preferred.
Minimum Experience Required:
  • Required 5 years of revenue cycle experience.
  • Knowledge of Epic EMR software is a plus.
Minimum Knowledge and Skills Required:
  • Knowledge of Epic EMR software is a plus.
  • Understanding and proficient use of medical billing guidelines and regulations.
  • Knowledge of regulations as set forth by CMS, OIG, commercial insurances and other regulatory agencies.
  • Knowledge of CPT, ICD-10, and HCPCS codes, as well as appropriate modifier usage for billing and following up on open AR claims.
  • Familiar with billing all major medical insurances, including Medicare, Tricare, and commercial payers.
  • Ability to communicate effectively and congenially with patients and staff members in person and over the phone.
  • Ability to exercise tact, initiative, and good judgement when interacting with patients and staff members.
  • Working experience in Office 365 business tools such as Outlook, Excel, Word etc.
  • Ability to navigate and accurately input within the Practice Management System.
  • Ability to navigate in the EMR and other source systems.
  • Ability to accept supervision and feedback.
  • Ability to look for patterns of events, provides feedback and solutions.
  • Critical thinking and analytical skills to review accounts and medical documentation.

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